Provider Demographics
NPI:1336313014
Name:YOO, KUM (MD)
Entity Type:Individual
Prefix:
First Name:KUM
Middle Name:
Last Name:YOO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 TALAVERA RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-4528
Mailing Address - Country:US
Mailing Address - Phone:954-389-5627
Mailing Address - Fax:
Practice Address - Street 1:595 TALAVERA RD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-4528
Practice Address - Country:US
Practice Address - Phone:954-389-5627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program